Virilization
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
More about the experts All content is checked by medical journalists.
Virilization (masculinization) describes the development of male sexual characteristics in women, for example male hair, deep voice and the absence of menstruation. The trigger is an overproduction of male sex hormones. Read more about the causes and treatment of virilization here.
Virilization: description
Doctors speak of virilization when women develop male secondary sexual characteristics:
- Male hair such as beard hair, chest hair (hirsutism)
- Lower voice range
- Unusually large clitoris (clitoral hypertrophy)
- Missing menstrual period (amenorrhea)
- Male body proportions
The reason for the masculinization of women is an increased production of male sex hormones (androgens such as testosterone). The reasons could be diseases of the adrenal glands, ovaries or the use of certain medications.
Virilization: causes and possible diseases
The main causes of virilization are:
- Adrenal gland tumor: Sometimes virilization is due to an adrenal gland tumor that produces male sex hormones (androgens).
- Adrenogenital Syndrome (AGS): This adrenal disease is a congenital disorder of hormone production by the adrenal glands. The result is masculinization with a broken voice, a lack of menstrual bleeding and - in classic AGS - masculinization of the external female genitals already in the womb.
- Ovarian (ovarian) tumor: An ovarian tumor that produces androgens can cause beard growth, deep voice, and other signs of masculinization.
- Polycystic Ovarian Syndrome (PCO syndrome): This malfunction of the ovaries is characterized by a lack of menstrual bleeding (amenorrhea), obesity (obesity), male hairiness (hirsutism) and sometimes other signs of virilization. These include, for example, a deep voice, underdeveloped breasts, and an oversized clitoris.
- Hyperthecosis ovarii: This very rare dysfunction of the ovaries is associated with a pronounced formation of androgens and a strong masculinization.
- Drugs: Various drugs can cause virilization, such as androgens (anabolic steroids, doping agents) and ACTH (e.g. rheumatism). The epilepsy drug phenytoin can also trigger masculinization with hirsutism (beard growth, etc.).
Virilization: When Should You See a Doctor?
A suddenly occurring virilization should definitely be clarified by a doctor. There could be an adrenal or ovarian tumor behind it.
Virilization: what does the doctor do?
The doctor will first ask you in detail about your medical history (anamnesis). For example, it is important when and what signs of masculinization you noticed or whether you are taking medication. It is also interesting to see how your menstrual cycle works or whether your menstrual period has stopped. The following examinations will help in finding the exact cause of the virilization:
- Gynecological Exam: Routine for signs of masculinization in women.
- Blood tests: First, the testosterone level in the blood is measured. If it is normal, it rules out an androgen-producing tumor in the adrenal glands or ovaries as the cause of the virilization.If, on the other hand, the testosterone level is increased, the concentration of another hormone (dehydroepiandrosterone) is determined: If this is also increased, this indicates an adrenal disease as the reason for masculinization.
- Imaging procedures: Ultrasound examinations (sonography) and computed tomography (CT) help diagnose androgen-producing tumors in the adrenal glands or ovaries as triggers for virilization. The ultrasound also shows the numerous small cysts on the edge of the ovaries, as they often occur in women with polycystic ovary syndrome.
If there is a specific suspicion, further investigations are necessary. To find out, for example, whether the adrenogenital syndrome (AGS) is the cause of virilization, the hormone ACTH is administered as a test. If the blood level of the body's own hormone alphahydroxyprogesterone then rises excessively, you probably have AGS.
If polycystic ovaries are suspected, other hormone levels in the blood are determined, for example LH and FSH.
This is how virilization can be treated
The focus is on the treatment of the disease on which the virilization is based. For example, androgen-producing tumors in the adrenal glands or ovaries are operated on.
If masculinization is based on adrenogenital syndrome (AGS), medication usually has to be taken for life. A masculinized external genitalia (enlarged clitoris, reduced vaginal entrance), such as occurs in classic AGS from birth, is operated on at an early stage. Normal sexual intercourse and pregnancy are possible later.
The treatment of polycystic ovary syndrome is very tedious; Different medications are given depending on the patient's needs and complaints.
Virilization: You Can Do It Yourself
There is not much you can do yourself about the cause of virilization. However, beard growth and other forms of male hair (hirsutism) that occur as part of masculinization can be addressed with cosmetic treatments such as shaving and epilation.
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